Kyung-Uk Lee

Color vision in Parkinson’s disease and essential tremor

Background and purpose:  Decreased visual function is one of the non‐motor dysfunctions of Parkinson’s disease (PD). Recent evidences suggest that essential tremor (ET) is not ‘pure’ motor disorder and there is growing evidence that this disease is a multiple‐system disorder. In some cases, it is difficult to differentiate ET from PD. In addition, there is considerable controversy regarding the relationship between PD and ET. The objective of this study was to compare color discrimination dysfunction amongst patients with PD and ET and to investigate the clinical relevance.

Effects of zonisamide on isolated head tremor

Background and purpose:  The medical treatment available for patients with essential tremor (ET) is often inadequate. Furthermore, the efficacy of the medical treatments currently available for patients with ET of cranial nerve areas is less satisfactory than that of the medical treatments available for patients with ET involving the upper extremities. This pilot study was performed to evaluate whether zonisamide (ZNS) is effective in the treatment of patients with isolated head tremor.

Temporal Changes in Functional Magnetic Resonance Imaging Activation of Heterosexual Couples for Visual Stimuli of Loved Partners

Objective Previous neuroimaging studies on romantic love have focused on determining how the visual stimuli that serve as a representation of loved ones induce the neural activation patterns of romantic love. The purpose of this study was to investigate the temporal changes in romantic love over a period of 6 months and their correlated neurophysiological changes. Methods Five heterosexual couples (n=10, mean age 21.1±1.97) who started dating not less than 100 days previously were recruited to measure their blood oxygen level dependent (BOLD) signals using functional magnetic resonance imaging (fMRI) while showing them pictures of their loved ones and their previously identified, opposite-sex friends. Subsequently, the subjects were scanned under the same experimental conditions to assess possible changes in their brain activities after 180 days. Results We found that their Passionate Love Score (PLS) values (M: 118.6±9.1, F: 120.2±7.0) were significantly reduced after 6 months (M: 110.8±4.0, F: 106.2±3.0). Furthermore, significantly increased activations were found in the cingulate gyri, inferior frontal gyri, supramarginal gyri, etc., after 6 months, whereas the head and tail of the right caudate nucleus were deactivated, which is indicative of the inhibition of expression and sensory neglect. Conclusion These findings suggest that dynamic neural processes in the cortical-subcortical regions are involved in temporal changes in romantic love.

Assessing migraine disability by diary-based measurement: relationship to the characteristics of individual headache attacks

Background and purpose:  Information on headache‐related disability helps clinicians create the optimal treatment plan for migraine sufferers. The estimation of disability must be determined by gathering the individual effects of multiple headache attacks within a given period of time. This study was aimed to examine migraine‐related disability from diary‐based assessment and to determine which elements of the headache characteristics are associated with disability.

Risperidone in the treatment of mixed state bipolar patients: Results from a 24‐week, multicenter, open‐label study in Korea

Aims:  The goal of the present study was to evaluate the efficacy of risperidone combined with mood stabilizers for treating bipolar mixed state.

Recurrent thunderclap headache triggered by singing.

Sir, Thunderclap headache (TCH) is an acute, severe headache that reaches maximum intensity during its onset. A TCH might be the first sign of subarachnoid hemorrhage, unruptured intracranial aneurysm, cerebral venous sinus thrombosis, cervical artery dissection, spontaneous intracranial hypotension, acute hypertensive crisis, or a third ventricle colloid cyst [1]. A primary TCH, a diagnosis to consider when the more serious causes have been excluded, has been described as a distinct entity. When associated with coughing, exercise and sexual activity, the headache can be classified as a primary coughing headache, a primary exertional headache or a primary headache associated with sexual activity [1,2]. Here, we report the case of a patient with recurrent TCH associated with singing.

Coital transient ischaemic attacks

Sir, Cerebral ischaemia during sexual intercourse has been rarely reported in the medical literature. The presence of vasospasm with a coital headache or a paradoxical embolism from a patent foramen ovale has been suggested as the probable underlying mechanisms of cerebral ischaemia that can occur during sexual intercourse [1–4]. We describe a patient who had episodes of a transient ischaemic attack (TIA) associated with coitus. The mechanism underlying these episodes may be different from that described in previous reports.

Efficacy and safety of generic escitalopram (Lexacure®) in patients with major depressive disorder: a 6-week multicenter, randomized, rater-blinded, escitalopram-comparative, non-inferiority study

Objectives The primary aim of this non-inferiority study was to investigate the clinical effectiveness and safety of generic escitalopram (Lexacure®) versus branded escitalopram (Lexapro®) for patients with major depressive disorder (MDD). Methods The present study included 158 patients, who were randomized (1:1) to receive a flexible dose of generic escitalopram (n=78) or branded escitalopram (n=80) over a 6-week single-blind treatment period. The clinical benefits in the two groups were evaluated using the Montgomery–Åsberg Depression Rating Scale (MADRS), the 17-item Hamilton Depression Rating Scale (HDRS), the Clinical Global Impressions-Severity scale (CGI-S), and the Clinical Global Impressions-Improvement scale (CGI-I) at baseline, week 1, week 2, week 4, and week 6. The frequency of adverse events (AEs) was also assessed to determine safety at each follow-up visit. Results During the 6-week study period, 30 patients (38.5%) from the generic escitalopram group and 28 patients (30.0%) from the branded escitalopram group dropped out of the study (P=0.727). The MADRS, HDRS, CGI-S, and CGI-I scores significantly decreased in both groups, and there were no significant differences between the groups. At week 6, 28 patients (57.1%) in the generic escitalopram group and 35 patients (67.3%) in the branded escitalopram group had responded to treatment (as indicated by a ≥50% decrease from the baseline MADRS score; P=0.126), and the remission rates (MADRS score: ≤10) were 42.9% (n=21) in generic escitalopram group and 53.8% (n=28) in the branded escitalopram group (P=0.135). The most frequently reported AEs were nausea (17.9%), sleepiness/somnolence (7.7%), weight gain (3.8%), and dry mouth (2.6%) in the generic escitalopram group and nausea (20.0%), sleepiness/somnolence (3.8%), weight gain (2.5%), and dry mouth (2.5%) in the branded escitalopram group. Conclusion The present non-inferiority study demonstrated that generic escitalopram is a safe and an effective initial treatment for patients with MDD and may also be considered as an additional therapeutic option for this population.